DICLOFENAC

DICLOFENAC (1300K)

diclofenac sodium 50 mg enteric tablet, 50
1300K
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 50 # of repeats: 3 DPMQ: $16.70 Max safety net: $18.18 General Patient Charge: $20.97
Available brands
Clonac 50
DICLOFENAC-WGR
Diclofenac Sandoz
Fenac EC
Voltaren 50
*Additional charge for this brand is $9.95
 DPMQ: $26.65 Max safety net: $18.18 General Patient Charge: $30.92

DICLOFENAC (5077F)

diclofenac sodium 50 mg enteric tablet, 50
5077F
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 50 # of repeats: 0 DPMQ: $16.70 Max safety net: $18.18 General Patient Charge: $20.97
Available brands
Clonac 50
DICLOFENAC-WGR
Diclofenac Sandoz
Fenac EC
Voltaren 50
*Additional charge for this brand is $9.95
 DPMQ: $26.65 Max safety net: $18.18 General Patient Charge: $30.92